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Evidence supporting a link between gait and cognition is accumulating. However, the relation between executive functioning and spatiotemporal gait parameters has received little attention. This is surprising since these gait variables are related to falls. The goal of this preliminary study was to determine whether performance on measures of inhibition, reasoning, and fluency is related to variability in stride length and step width during dual-task treadmill walking in a sample of healthy adults. Nineteen healthy adults averaging 40 years of age were evaluated. Results indicated that processing speed was reduced, t(18) = 6.31, p = 0.0001, step width increased, t(18) = −8.00, p = 0.0001, and stride length decreased, t(18) = 3.06, p = 0.007, while dual tasking, but variability in gait parameters did not significantly change, consistent with a gait/posture-first approach. As hypothesized, better performance on a visual design fluency task which assesses cognitive flexibility was associated with less dual-task stride length variability, rs(17) = −0.43, p = 0.034, and step width variability, r = −0.56, p = 0.006. The results extend previous findings with older adults walking over ground and additionally suggest that cognitive flexibility may be important for gait maintenance while dual tasking.

Valeria Magarotto,1 Julien Thevenon,2 Kate Morgan,3 Silene ten Seldam,3 Wafae Iraqi,4 Xavier Guillaume,5 Marjorie Leclerc,5 Claire Graziani-Taugeron,5 Bleuenn Rault,5 Dahbia Horchi5 1MD, Janssen-Cilag, Cologno Monzese, MI, Italy; 2Medical Affairs, Janssen Pharmaceuticals, Issy-les-Moulineaux, France; 3Myeloma Patients Europe, Brussels, Belgium; 4Patient Engagement, Janssen Pharmaceuticals, Issy-les-Moulineaux, France; 5RWE Data & Analytics, Oracle Life Sciences, Paris, FranceCorrespondence: Xavier Guillaume; Claire Graziani-Taugeron, Oracle France, 198 Avenue de France, Paris, 75013, France, Email xavier.guillaume@oracle.com; claire.graziani-taugeron@oracle.comPurpose: To provide real-world data on patient perceptions and experiences with subcutaneous (SC) versus intravenous (IV) daratumumab.Patients and Methods: This was a cross-sectional, mixed-method (qualitative/quantitative) survey conducted in France, Germany, Spain and the United Kingdom involving multiple myeloma (MM) patients who switched from IV to SC daratumumab in the last 12 months (qualitative phase) or 24 months (quantitative phase [26 months in the UK]) prior to enrollment in the study.Results: Nine patients (mean age 65 years) participated in the qualitative phase and 113 patients (mean age 65.1 years) in the quantitative phase. Qualitative study results provided insights for the quantitative study and highlighted the benefits of switching from daratumumab IV to daratumumab SC as an improvement and a satisfactory change in patients’ treatment journey. Quantitative survey showed that patients were significantly less anxious, stressed and nervous before SC injections than IV infusions (mean score: 1.3, 1.1, 1.4 versus 2.1, 2.0, 2.0 respectively, p< 0.001), and significantly more reassured, ready/well-prepared, usual self and relieved (mean score: 3.8, 4.3, 3.7, 3.6 versus 3.0, 3.6, 3.1, 3.0 respectively, p< 0.001). Immediately after SC first injection, 96.5% patients were feeling well or very well versus 77.9% immediately after IV first infusion (p< 0.001). 97.3% patients were satisfied with their SC treatment versus 89.4% for the IV injection (p< 0.001). Patients spent significantly less time in hospital for an SC injection of daratumumab than for an IV infusion, 1.5 hours and 5.0 hours respectively (p< 0.001). In the UK, the differences between the two administration forms were less visible, likely because of confounding factors including a longer time passed since the switch from the IV to the SC form and administration of the survey.Conclusion: In line with results from other studies, the SC form of daratumumab had less impact on patients’ emotional burden than the IV form.Keywords: multiple myeloma, daratumumab, mode of administration, patients’ emotional burden, mixed method

Abstract Oxidative stress is a key contributor to AD pathology. However, the earliest role of pre-plaque neuronal oxidative stress, remains elusive. Using laser microdissected hippocampal neurons extracted from McGill-R-Thy1-APP transgenic rats we found that intraneuronal amyloid beta (iAβ)-burdened neurons had increased expression of genes related to oxidative stress and DNA damage responses including Ercc2, Fancc, Sod2, Gsr, and Idh1. DNA damage was further evidenced by increased neuronal levels of XPD (Ercc2) and γH2AX foci, indicative of DNA double stranded breaks (DSBs), and by increased expression of Ercc6, Rad51, and Fen1, and decreased Sirt6 in hippocampal homogenates. We also found increased expression of synaptic plasticity genes (Grin2b (NR2B), CamkIIα, Bdnf, c-fos, and Homer1A) and increased protein levels of TOP2β. Our findings indicate that early accumulation of iAβ, prior to Aβ plaques, is accompanied by incipient oxidative stress and DSBs that may arise directly from oxidative stress or from maladaptive synaptic plasticity.

OBJECTIVES:. To assess the in vitro IntelliSep test, a microfluidic assay that quantifies the state of immune activation by evaluating the biophysical properties of leukocytes, as a rapid diagnostic for sepsis. DESIGN:. Prospective cohort study. SETTING:. Five emergency departments (EDs) in Louisiana, Missouri, North Carolina, and Washington. PATIENTS:. Adult patients presenting to the ED with signs (two of four Systemic Inflammatory Response Syndrome criteria, where one must be temperature or WBC count) or suspicion (provider-ordered culture) of infection. INTERVENTIONS:. All patients underwent testing with the IntelliSep using ethylene diamine tetraacetic acid-anticoagulated whole blood followed by retrospective adjudication for sepsis by sepsis-3 criteria by a blinded panel of physicians. MEASUREMENTS AND MAIN RESULTS:. Of 599 patients enrolled, 572 patients were included in the final analysis. The result of the IntelliSep test is reported as the IntelliSep Index (ISI), ranging from 0.1 to 10.0, divided into three interpretation bands for the risk of sepsis: band 1 (low) to band 3 (high). The median turnaround time for ISI results was 7.2 minutes. The ISI resulted band 1 in 252 (44.1%), band 2 in 160 (28.0%), and band 3 in 160 (28.0%). Sepsis occurred in 26.6% (152 of 572 patients). Sepsis prevalence was 11.1% (95% CI, 7.5–15.7%) in band 1, 28.1% (95% CI, 21.3–35.8%) in band 2, and 49.4% (95% CI, 41.4–57.4%) in band 3. The Positive Percent Agreement of band 1 was 81.6% and the Negative Percent Agreement of band 3 was 80.7%, with an area under the receiver operating characteristic curve of 0.74. Compared with band 1, band 3 correlated with adverse clinical outcomes, including mortality, and resource utilization. CONCLUSIONS:. Increasing ISI interpretation band is associated with increasing probability of sepsis in patients presenting to the ED with suspected infection.

Brain oscillations have been hypothesized to support cognitive function by coordinating spike timing within and across brain regions, yet it is often not known when timing is either critical for neural computations or an epiphenomenon. The entorhinal cortex and hippocampus are necessary for learning and memory and exhibit prominent theta oscillations (6-9 Hz), which are controlled by pacemaker cells in the medial septal area. Here we show that entorhinal and hippocampal neuronal activity patterns were strongly entrained by rhythmic optical stimulation of parvalbumin-positive medial septal area neurons in mice. Despite strong entrainment, memory impairments in a spatial working memory task were not observed with pacing frequencies at or below the endogenous theta frequency and only emerged at frequencies ≥10 Hz, and specifically when pacing was targeted to maze segments where encoding occurs. Neural computations during the encoding phase were therefore selectively disrupted by perturbations of the timing of neuronal firing patterns.

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: Anecdotal evidence suggests patients who require midfoot fusion following initial open reduction and internal fixation (ORIF) for Lisfranc injury fare worse than those treated with an index arthrodesis, despite an identical final construct. Substantial data has been generated to understand optimal initial treatment of Lisfranc injuries; however, no data exists comparing the primary arthrodesis (PA) and secondary fusion (SA) populations. The purpose of this study was to compare radiographic and patient reported outcomes (PROs) of patients who underwent PA versus SA following ORIF of their Lisfranc injury. Methods: We retrospectively identified skeletally mature patients from an academic level 1 trauma center treated for midfoot injuries between 2002-2022. We identified 232 patients (234 feet) with Lisfranc injuries. A total of 65 patients underwent a fusion procedure and were included in our cohort. Demographic data, treatment, radiographic outcomes, and PROs were recorded. Patients who underwent PA as index treatment of their Lisfranc injury were compared to those who underwent index ORIF and subsequent SA. We used a composite primary outcome for comparison which included: the development of adjacent midfoot arthrosis, midfoot collapse, or mal/nonunion. Secondary outcomes were PROMIS measures of physical function (PF) and pain interference (PI). Descriptive statistics, chi-squared, and independent sample t-tests were employed for analysis. Multivariable analysis was utilized to determine the contribution of confounders on outcome. Logistic regression was used to ascertain effects of index treatment on outcome probability. Results: 42 underwent index PA (18%); 23 SAs were required (12.3% of index ORIFs). Average follow-up was 4.3 years (0.3- 18.2y). Mean age at fusion was 48.3 years; average time from index to fusion was 3.1 years (SD 5.29y). Poor radiographic outcomes were noted in 2 PA patient (5.3%) compared to 5 SA (27.8%, p=0.02). Logistic regression indicated those requiring SA were 6.9 times more likely to exhibit poor radiographic outcomes (p=0.03). A non-significant trend demonstrated higher PF and lower PI scores after index PA versus primary ORIF and SA (42.5 vs 39.0, p=0.17; 56.3 vs. 61.6, p=0.06). There was otherwise no difference in PROs between groups. Logistic regression revealed no significant prediction of PROs by treatment. Post-hoc power analysis indicated 32% power to detect PRO differences. Conclusion: While this study does not reveal robust evidence to advocate for primary fusion of every Lisfranc, results may suggest a suboptimal outcome if a patient requires SA after index ORIF compared to PA. This may be in part to effects of repeat surgery. Findings should prompt further larger scale investigations to better elucidate the merits of a single surgery approach, and warrant consideration of how to predict who might be at risk to require SA so to advocate for PA as their index procedure.

Epiphytic lichens and bryophytes provide important habitat for microarthropods, yet little work has documented epiphytic microarthropod assemblages. Further, the response of epiphytes and their associated microarthropod communities to varying levels of forest disturbance and cutting intensity are not well known. We conducted a case study to provide an initial community description of epiphyte-dwelling microarthropods in Adirondack northern hardwoods, and to assess potential for impacts of aggregated and dispersed patterns of reserve tree retention to these communities. In total, 79 families of microarthropods were identified in the 0.14 m2 of samples. Late summer average daily maximum temperatures were 3.2 °C higher in the shelterwood, and three years following treatments the per-unit area dry weight of the bole-associated bryophyte Neckera pennata was 34 % lower in the shelterwood. Microarthropod richness and density were distinctly greater in epiphyte substrates at the base of trees, and were reduced in the shelterwood. Several indicator taxa were identified within the basal bryophytes in the reserve treatment, and in both bryophytes the microarthropod assemblages were more homogenous in the shelterwood. A few mobile and heavily sclerotized taxa persisted in shelterwood substrates, especially in the lichens which lacked 3-dimensional structure. This case study revealed a diverse community of microarthropods in northern hardwood forests that were structured by epiphyte type, height on tree and, potentially, by canopy removal, and suggests conservation value of aggregated tree retention when applying even-age regeneration methods with respect to epiphytic bryophytes, lichens, and their associated invertebrates.

The central role of RNAs in health and disease calls for robust tools to visualize RNAs in living systems through fluorescence microscopy. Live zebrafish embryos are a popular system to investigate multicellular complexity as disease models. However, RNA visualization approaches in whole organisms are notably underdeveloped. Here, we establish our RNA tagging and imaging platform Riboglow-FLIM for complex cellular imaging applications by systematically evaluating FLIM capabilities. We use adherent mammalian cells as models for RNA visualization. Additional complexity of analyzing RNAs in whole mammalian animals is achieved by injecting these cells into a zebrafish embryo system for cell-by-cell analysis in this model of multicellularity. We first evaluate all variable elements of Riboglow-FLIM quantitatively before assessing optimal use in whole animals. In this way, we demonstrate that a model noncoding RNA can be detected robustly and quantitatively inside live zebrafish embryos using a far-red Cy5-based variant of the Riboglow platform. We can clearly resolve cell-to-cell heterogeneity of different RNA populations by this methodology, promising applicability in diverse fields.

BackgroundMany children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact during early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely.MethodsThis was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children's Health data. The sample included 19,482 U.S. children ages 0-5 years including 242 very low birthweight (VLBW) and 2205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e.,

Diffusely infiltrating gliomas are known to cause alterations in cortical function, vascular disruption, and seizures. These neurological complications present major clinical challenges, yet their underlying mechanisms and causal relationships to disease progression are poorly characterized. Here, we follow glioma progression in awake Thy1-GCaMP6f mice using in vivo wide-field optical mapping to monitor alterations in both neuronal activity and functional hemodynamics. The bilateral synchrony of spontaneous neuronal activity gradually decreases in glioma-infiltrated cortical regions, while neurovascular coupling becomes progressively disrupted compared to uninvolved cortex. Over time, mice develop diverse patterns of high amplitude discharges and eventually generalized seizures that appear to originate at the tumors' infiltrative margins. Interictal and seizure events exhibit positive neurovascular coupling in uninfiltrated cortex; however, glioma-infiltrated regions exhibit disrupted hemodynamic responses driving seizure-evoked hypoxia. These results reveal a landscape of complex physiological interactions occurring during glioma progression and present new opportunities for exploring novel biomarkers and therapeutic targets.

Kate Morgan,1 Angela Smith,2 Svetlana Blitshteyn3,4 1School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, New South Wales, Australia; 2HNE Health Libraries, Hunter New England Local Health District, Newcastle, New South Wales, Australia; 3Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA; 4Dysautonomia Clinic, Williamsville, NY, USACorrespondence: Svetlana Blitshteyn, 300 International Drive, Suite 100, Williamsville, NY, 14221, USA, Tel +1-716-531-4598, Fax +1-716-478-6917, Email sb25@buffalo.eduAbstract: Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system most commonly affecting women of reproductive age. Studies on POTS and pregnancy are limited, and there is a lack of clinical guidelines regarding assessment and management of pregnant women with POTS. The purpose of this review is to summarize data from the available studies on the topic of pregnancy in POTS and common comorbid conditions and to provide the clinical recommendations regarding evaluation and treatment of POTS in pregnant women, based on the available studies and clinical experience. We conclude that pregnancy appears to be safe for women with POTS and is best managed by a multi-disciplinary team with knowledge of POTS and its various comorbidities. Importantly, large, prospective studies are needed to better delineate the course and outcomes of pregnancy, as well as possible pregnancy-related complications in women with POTS. Clinicians should be aware of the clinical presentation, diagnostic criteria, and treatment options in pregnant women with POTS to optimize outcomes and improve medical care during pregnancy and post-partum period.Keywords: POTS, pregnancy, Ehlers-Danlos syndrome, migraine, post-partum

Xenia Gatopoulou,1 Wafae Iraqi,2 Kate Morgan,3 Kawitha Helme,4 Victoria A Spain,5 Jennifer Redfearn,5 Brett Gardiner5 1Health Economics, Market Access and Reimbursement EMEA, Janssen Pharmaceuticals, Athens, Greece; 2Patient Engagement, Janssen Pharmaceuticals, Issy-les-Moulineaux, France; 3Myeloma Patients Europe, Brussels, Belgium; 4Health Economics, Market Access and Reimbursement EMEA, Janssen Pharmaceuticals, High Wycombe, UK; 5The Research Partnership, London, UKCorrespondence: Wafae Iraqi, Janssen Pharmaceuticals, 1, Rue Camille Desmoulins, TSA 91003, Issy-les-Moulineaux, 92787, France, Email wiraqi@its.jnj.comBackground: This research aimed to quantify the burden of illness (BoI) in transplant eligible (TE) and transplant non-eligible (TNE) newly diagnosed multiple myeloma (NDMM) patients and their caregivers, in the first year after diagnosis: at months 0, 3, and 12.Methods: Prospective, cross-sectional, observational NDMM study of TE and TNE patients and their caregivers from France, Germany, Italy, and Spain was conducted between May 2019 and January 2021. A structured, online questionnaire measuring disease burden, direct and costs, out-of-pocket expenses, and health-related quality of life (HRQoL) was used. Descriptive statistics were performed.Results: A total of 164, 160, and 190 NDMM patients [> 65 years; self-described healthy; not working; living with caregiver] answered at months 0, 3, and 12. Patients lost independence to perform daily activities; mean pain intensity rose and opioid utilization increased, more significantly among TNE patients. Overall health status and HRQoL remained stable. Median 3-month direct medical costs peaked at month 3. Specialist consultations and hospital admissions were the greatest cost amongst TE and TNE patients. Home adaptations increased out-of-pocket expenditures amongst TNE patients. Patients describing themselves as working spent a median 0 hours in the office at all time points. A total of 131, 122, and 124 caregivers answered at months 0, 3, and 12. Mean self-rated burden score rose. By month 12, half of caregivers developed stress, anxiety or depression. Most employed caregivers continued working. Productivity was low at month 0 with a trend of recovering at month 12. Caregivers of TNE compared to TE patients reported greater time burden. Caregivers’ HRQoL was stable over time.Conclusion: NDMM is burdensome for patients and caregivers in the first year after diagnosis. TNE patients are more dependent on caregivers and incur higher care costs than TE patients. Despite the financial, physical, and emotional burden, HRQoL remains stable possibly indicating resilience and illness adjustment amongst patients and caregivers.Keywords: burden of illness, costs of disease, newly diagnosed multiple myeloma, health-related quality of life

John Dewey was a pragmatist, progressivist, educator, philosopher, and social reformer (Gutek, 2014). Dewey's various roles greatly impacted education, and he was perhaps one of the most influential educational philosophers known to date (Theobald, 2009). Dewey's influence on education was evident in his theory about social learning; he believed that school should be representative of a social environment and that students learn best when in natural social settings (Flinders & Thornton, 2013). His ideas impacted education in another facet because he believed that students were all unique learners. He was a proponent of student interests driving teacher instruction (Dewey, 1938). With the current educational focus in the United States being on the implementation of the Common Core standards and passing standardized tests and state exams, finding evidence of John Dewey's theories in classrooms today can be problematic (Theobald, 2009). Education in most classrooms today is what Dewey would have described as a traditional classroom setting. He believed that traditional classroom settings were not developmentally appropriate for young learners (Dewey, 1938). Although schools, classrooms, and programs that support Dewey's theories are harder to find in this era of testing, there are some that still do exist. This paper will explore Responsive Classroom, Montessori Schools, Place-Based Education, and Philosophy for Children (P4C), all of which incorporate the theories of John Dewey into their curricular concepts.

Ian Boggero,1,2 Cecelia Valrie,3,4 Krystal Morgan,5 Nao Hagiwara,3 Susmita Kashikar-Zuck,2,6 Christopher King2,6 1Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky College of Dentistry, Lexington, KY, USA; 2Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 3Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; 4Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA; 5Division of Transplant, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 6Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USACorrespondence: Ian Boggero, 740 S Limestone, Lexington, KY, 40536, USA, Tel +859-562-3291, Email ian.boggero@uky.eduContext: General fatigue, sleep-related fatigue, and cognitive fatigue are prevalent and disruptive in adults with chronic musculoskeletal (MSK) pain, but little is known about these fatigue subtypes in pediatric musculoskeletal pain.Objective: To compare fatigue and its subtypes between adolescents with chronic MSK pain and pain-free controls and to test if fatigue subtypes were associated with concurrent pain and its impact (pain intensity, number of pain sites, pain interference, and functional disability) or experimental pain (intensity and tolerance) in adolescents with chronic MSK pain. Finally, we sought to explore adolescents’ qualitative characterizations of their fatigue.Methods: Adolescents with chronic MSK pain (12– 17 y.o., n = 26) and pain-free controls (n = 26) completed validated self-report measures of fatigue, pain, and functional disability, underwent an experimental pain tolerance task (cold water immersion of the hand), and provided qualitative descriptions of their fatigue (pain group only).Results: Adolescents with chronic MSK pain reported significantly greater general, sleep-related, and cognitive fatigue than pain-free controls (all p’s < 0.001). In adolescents with chronic MSK pain, fatigue subtypes were associated with clinical pain and pain impact (r’s = 0.43– 0.84) but not experimental pain measures (p’s > 0.05). Adolescents with chronic MSK pain qualitatively described the negative implications of the different fatigue subtypes, particularly when perceived as long-lasting.Conclusion: This preliminary study suggests that fatigue subtypes are prevalent and impactful in pediatric patients with chronic MSK pain. When planning multi-disciplinary treatment for pediatric MSK pain, providers should recognize fatigue as another disabling symptom.Keywords: disability, fatigue, pediatric, musculoskeletal pain, widespread bodily pain

Cognitive–achievement relations research has been instrumental in understanding the development of academic skills and learning difficulties. Most cognitive–achievement relations research has been conducted with large samples and represent average relations across the ability spectrum. A notable gap in the literature is whether these relations vary by cognitive ability levels (IQ). This study examined cognitive–achievement relations across different general ability levels (Low, Average, and High) to fill this gap. Based on Spearman’s Law of Diminishing Returns, it would be expected that general intelligence would be a stronger predictor of academic skills at lower levels of IQ, and more specific abilities would be stronger predictors of academic skills at higher levels of IQ. To test this, multi-group path analysis and structural equation modeling were used to examine whether integrated models of cognitive–reading relations are differentiated by IQ levels in the Woodcock–Johnson III and Woodcock–Johnson IV standardization samples. Global and broad cognitive abilities were used as predictors of basic reading skills and reading comprehension for elementary and secondary school students. The magnitude of prediction differed across ability groups in some cases, but not all. Importantly, the variance explained in basic reading skills and reading comprehension tended to be larger for the Low group compared to the Average and High groups. When variance accounted for by general intelligence was removed from the broad abilities, the effects of the broad abilities were similar across ability groups, but the indirect effects of g were higher for the Low group. Additionally, g had stronger relative effects on reading in the Low group, and broad abilities had stronger relative effects on reading in the Average and High groups. The implications and limitations of this study are discussed.

Abstract Objective: Empiric broad-spectrum antibiotic therapy is commonly prescribed for patients hospitalized with diabetic foot infections (DFI) and lower extremity osteomyelitis (OM). The primary objective was to evaluate the concordance between empiric antibiotic therapy, microbiologic results, and definitive antibiotic therapy with a focus on methicillin-resistant Staphylococcus aureus (MRSA) and resistant gram-negative organisms. The secondary objective was to evaluate the negative predictive values (NPV) of select risk factors for MRSA and resistant gram-negative organisms for microbiologic results with these organisms. Design: Retrospective cohort study. Setting: Safety-net health system in Ohio. Patients: Adults hospitalized and receiving antibiotic therapy for DFI or lower extremity OM in 2021. Results: For 259 unique patients, empiric therapies with activity against MRSA and resistant gram-negative organisms were administered to 224 (86.5%) and 217 (83.8%) patients, respectively. Definitive therapies with activity against MRSA and resistant gram-negative organisms were administered to 91 (35%) and 74 (28.6%) patients, respectively. Of 234 patients with microbiologic testing, 29 (12.4%) had positive cultures with MRSA and 41 (17.5%) with resistant gram-negative organisms. The NPVs of risk factors for MRSA and resistant gram-negative organisms for the absence of these organisms in culture were 91% and 85%, respectively. Conclusions: For patients hospitalized with DFI and lower extremity OM, our data suggest opportunities for substantial reductions in empiric therapies with activity against MRSA and resistant gram-negative organisms. The absence of risk factors for these organisms was reasonably good at predicting negative cultures with these organisms.

During the COVID-19 pandemic, individuals depended on risk information to make decisions about everyday behaviors and public policy. Here, we assessed whether an interactive website influenced individuals' risk tolerance to support public health goals. We collected data from 11,169 unique users who engaged with the online COVID-19 Event Risk Tool (https://covid19risk.biosci.gatech.edu/) between 9/22/21 and 1/22/22. The website featured interactive elements, including a dynamic risk map, survey questions, and a risk quiz with accuracy feedback. After learning about the risk of COVID-19 exposure, participants reported being less willing to participate in events that could spread COVID-19, especially for high-risk large events. We also uncovered a bias in risk estimation: Participants tended to overestimate the risk of small events but underestimate the risk of large events. Importantly, even participants who voluntarily sought information about COVID risks tended to misestimate exposure risk, demonstrating the need for intervention. Participants from liberal-leaning counties were more likely to use the website tools and more responsive to feedback about risk misestimation, indicating that political partisanship influences how individuals seek and engage with COVID-19 information. Lastly, we explored temporal dynamics and found that user engagement and risk estimation fluctuated over the course of the Omicron variant outbreak. Overall, we report an effective large-scale method for communicating viral exposure risk; our findings are relevant to broader research on risk communication, epidemiological modeling, and risky decision-making.